| How Payment is Calculated for
Participating Dental Products
Every spring we review Regence BCBSO dental
maximum allowable fees to ensure that fees are within
community standards. This process includes a review
of claims submitted during the past year by dentists
within Regence BCBSO's service area of the state of
Oregon and SW Washington. We also add a trending factor,
which allows us to adjust for inflation. The results
are above the range for average charges for a service
or supply billed by most providers or vendors for the
same or similar service or supply in our service area.
A Maximum Allowable Fee is determined for each service
or supply provided to your patients. The Maximum Allowable
Fee amount is the total amount you can expect to receive
in payment from the patient and payor combined.
Our Participating Dental Maximum Allowable Fee Schedules
are available online for participating dental professionals
who have access to Regence Online Services. Log
into Regence Online Services here.
If you are a participating dental professional, but
you do not have Regence Online Services access, please
contact our dental services
representatives directly to request a copy of our
fee schedules.
How Payment is Calculated for non-participating
Dental Products
Generally, we use an amount, determined by
us, which falls within the range of average charges
for a service or supply billed by most dental professionals
for the same or similar service or supply in our service
area.
However, there are times when we will create a special
fee schedule to fit a particular niche product. For
example, the BlueCare Fee Schedule below was created
for our BlueCare dental product, an alternative for
our small group market.
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